Heart failure (HF) is among the most common diseases in the western world and is responsible for Substantial morbidity and mortality. Although recent decades have seen improvements in therapy for HF, many important clinical questions remain unaddressed. Existing clinical trials have primarily focused on chronic HF in ambulatory patients, while a variety of other components of the HF syndrome, such as acute HF, advanced stage D HF, and HF with preserved systolic function, remain little studied and poorly understood. Additionally, the demographics of clinical trial patients often differ substantially from the broader heart failure population with regard to age, gender, race, and ethnicity. Existing infrastructure for multicenter, collaborative clinical research incorporating both academic and community sites is lacking, contributing to the lack of generalizable scientific progress. The Heart Failure Clinical Research Network is designed to create a national network of experienced, dedicated research teams to address critical unanswered questions in HF. The Heart Failure program at Duke University Medical Center has a long history of excellence in clinical care, research, and teaching. In particular, we have a track record of collaborative, high-quality, scientifically rigorous clinical research. We have long standing collaborative relationships with both academic centers and community practices throughout the region. We believe the combination of our expertise and experience with this substantial regional referral network would make us a valuable Regional Clinical Center (RCC) of the Heart Failure Clinical Trials Network. In this proposal, we have the following specific aims: 1) To collaborate with other RCCs and the Data Coordinating Center (DCC) in performing high quality, multi-center research addressing important unanswered questions in the field of HF. 2) To develop innovative, scientifically rigorous clinical protocols for consideration by the network, focused on clinically relevant unanswered questions in the field of HF 3) To leverage existing local and regional referral networks to maximize the participation of community sites in clinical protocols, and the dissemination of data into the broader clinical community 4) To create a Clinical Research Skills Development Core in order to train the next generation of clinical investigators to perform scientifically rigorous, high impact clinical research in the field of HF To accomplish these goals, we have assembled an experienced, dedicated team of investigators and academic and community partners. The successful accomplishment of these aims will be a significant contribution to both the Heart Failure Network and the overall care of patients with heart failure. (End of Abstract)